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General NPI Number Information
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NPI Number | 1295113223
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Entity Type | Individual
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Provider Name | TONY PHAN D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 431 NURSERY RD STE A600
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City | SPRING
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State | TX
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Zip | 77380-1987
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Country | US
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Telephone | 832-605-8993
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Fax | 844-364-4263
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Provider Business Mailing Address
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Address Line | 11463 GULLWOOD DR
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City | HOUSTON
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State | TX
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Zip | 77089-6821
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Country | US
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Telephone | 832-475-7960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 12932
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License Number State | TX
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